Related Experiment Video

Updated: May 17, 2026

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
04:56

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm

Published on: August 1, 2025

Mycotic aneurysms of the ascending aorta in the absence of endocarditis

Jayanta T Mukherjee1, Amit Nautiyal, Sherif B Labib

  • 1Department of Cardiology, Lahey Clinic, Burlington, Massachusetts 01805, USA.

Texas Heart Institute Journal
|October 31, 2012
PubMed

Insights

Mycotic aneurysms are rare but deadly infections of the aorta. Early diagnosis requires high clinical suspicion, even with advanced imaging, as illustrated by two elderly patients.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Mycotic aneurysms, rare complications of bacteremia, pose significant mortality risks.
  • Ascending aortic aneurysms with contained rupture (pseudoaneurysms) are particularly challenging cases.

Observation:

  • Two elderly patients (82 and 83 years old) presented with surgically confirmed mycotic aneurysms of the ascending aorta.
  • Neither patient had preceding valvular endocarditis, complicating initial diagnosis.
  • One patient with streptococcal bacteremia underwent successful resection; the other with staphylococcal bacteremia died post-repair due to patch dehiscence.

Findings:

  • Initial clinical suspicion for mycotic aneurysm was low in both cases, despite advanced imaging availability.
  • The diagnosis of mycotic aneurysm, particularly in the ascending aorta, was challenging.
  • Outcomes varied, with one successful surgical outcome and one fatal complication post-repair.

Implications:

  • Strong clinical suspicion is paramount for the early diagnosis of mycotic aneurysms.
  • Noninvasive imaging techniques, while crucial, may not suffice without high clinical suspicion.
  • Further research into optimal management strategies for ascending aortic mycotic aneurysms is warranted.
Keywords:
Aneurysm, infected/diagnosis/etiology/pathology/surgery/ultrasonographyanti-bacterial agents/therapeutic useaorta/pathology/surgeryaortic aneurysm/diagnosis/surgerystaphylococcus infections/complications/pathology

More Related Videos

Creation of Two Saccular Elastase-Digested Aneurysms with Different Hemodynamics in One Rabbit07:04

Creation of Two Saccular Elastase-Digested Aneurysms with Different Hemodynamics in One Rabbit

Published on: April 15, 2021

Murine Surgical Model of Topical Elastase Induced Descending Thoracic Aortic Aneurysm08:33

Murine Surgical Model of Topical Elastase Induced Descending Thoracic Aortic Aneurysm

Published on: August 24, 2019

Related Concept Videos

Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Endocarditis I: Introduction01:25

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...